How much rates vary
Facilitymedian $107 · 10th to 90th $95 to $178Professionalmedian $95 · 10th to 90th $50 to $4,169
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | None | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $17.78 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.91 | $9.55 | $9.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $93.33 Median $107.15 Typical High $177.83 | Facility | None | $93.33 | $107.15 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $95.50 Typical High $138.04 | Facility | None | $89.13 | $95.50 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | None | $89.13 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $44.67 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $17.78 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.91 | $9.55 | $9.55 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $6,760.83 | Facility | None | $141.25 | $141.25 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.18 Median $141.25 Typical High $7,943.28 | Professional | None | $28.18 | $141.25 | $7,943.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $162.18 | Facility | None | $104.71 | $107.15 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $144.54 | Facility | None | $109.65 | $112.20 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $223.87 | Professional | None | $107.15 | $112.20 | $223.87 |
United Setting Professional Modifier None Typical Low $15.14 Median $50.12 Typical High $53.70 | Professional | None | $15.14 | $50.12 | $53.70 |
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $83.18 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $81.28 | $83.18 | $87.10 |
Where Idaho sits
The same service costs 4.2 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 12th of 51
$95.50
HI $191NY $45.71
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.